| Street | 7100 W 171st St | ||
| City/Town | Tinley Park | ||
| State/Province/Region | Illinois | ||
| Zip/Postal Code | 60477 | ||
| Phone Number | (708) 532-8900 | ||
| Country | United States |
| Full Name | Mrs. Kara Wiza DDS | ||
| Gender | female | ||
| Birthday | 1995-05-10 | ||
| Social Security Number | 429-99-4359 |
| Credit card brand | EnRoute | ||
| Credit card number | 2014653485810648 | ||
| Expire | 2031/12 | ||
| CVV | 338 |